Page 117 - Journal of Structural Heart Disease Volume 5, Issue 4

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Meeting Abstracts
Among patients undergoing diagnostic catheterization without intervention, there was still a trend toward longer LOS with ICU admission compared with the floor (2 days [1.0-2.9] versus 1 [1.0-1.1], p=0.07).
Conclusions: Despite similar baseline characteristics, inter- stage patients have longer LOS when admitted to the ICU for observation versus the general floor after planned cath- eterization. They may also be exposed to extra interventions such as supplemental oxygen and feeding interruptions. Patients admitted to the floor uncommonly require trans- fer to the ICU and have no difference in survival to the next surgical palliation. While ICU admission after catheteriza- tion may be appropriate for some interstage patients, our findings suggest that routine ICU admission does not pro- vide benefit. Future work will investigate the resource uti- lization implications of these findings as related to overall cost and ICU bed space availability.
153. DILATED CARDIOMYOPATHY SECONDARY TO MIDDLE AORTIC SYNDROME: PALLIATIVE ENDOVAS- CULAR TREATMENT. CASE PRESENTATION AND LITER- ATURE REVIEW
Justo Santiago, Yudisay Molina, Andrea Lozano, Javier Castro, Camilo Espinel
Colombian cardiovascular foundation, Floridablanca, Colombia
Introduction: The medium aortic syndrome or coarctation of the abdominal aorta is a anomaly of idiopathic etiology or secondary to vasculitis of great vessels, characterized by a diffuse narrowing of the distal descending aorta or abdominal aorta (1).There are few reports at an early age and can rarely be presented asdilated cardiomyopathy (2).
Objective: We describe the clinical presentation of dilated cardiomyopathy secondary toAortic obstruction in a large area at the thoraco-abdominal level and the results of the endovascular palliative management.
Clinical Case: Female infant who, from 5 months of age, presented respiratory distress and radiological findings of cardiomegaly in control with diagnosis of dilated cardio- myopathy. At 8 months it was assessed in our institution, determining an ejection fraction of the left ventricle of 18%. And the finding was found to decrease the diame- ter of the descending and abdominal aorta to 2.6 mm, for which aortic aortic syndrome was suspected; corroborat- ing findings in angiotomography. Initial cerebral natriuretic peptide levels were elevated (2606 pg / ml), showing pro- gressive rise until reaching 4400 pg / ml despite optimal medical treatment. Therefore, it was decided to perform cardiac catheterization and salvage aortic angioplasty.
A peak to peak gradient between Aorta was determined during catheterization Thoracic and Abdominal Aorta of 34 mmHg and the aortogram corroborated the presence of a extensive area (57 mm long) of narrowing in the aorta towards thoraco-abdomen, with a diameter of 2.5 mm and irregular edges, extending to the emergency of the mes- enteric arteries.
Rescue angioplasty was performed with balloon 6 x 20 mm. Control angiography showed increase in the contrast column without dissection image or aneurysm. During the clinical control, at 6 months after the procedure, the patient presented improvement clinical and decreased levels of BNP . But the echocardiogram maintained a frac- tion of low ejection (25%) so a new catheterization was performed, finding an area of stenosis with images sug- gestive of dissection that were corroborated by ultrasound intravascular. Angioplasty was performed with a 9 mm x 45 mm stent, increasing the narrow area and limit the area of dissection. The subsequent clinical evolution was favor- able with greater decrease in the BNP levels and increase in the ejection fraction to 30%.
Conclusion: The present case raises that endovascular treatment is feasible as a measure palliative to achieve recovering cardiac function in a small patient with this pathology.
154. EARLY RESULTS WITH THE VENUS P-VALVE PER- CUTANEOUS IMPLANTATION IN NATIVE OUTFLOW TRACTS. A SINGLE CENTER EXPERIENCE
Diego Antoni1, German Henestrosa2, Oscar Mendiz 2
1Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina. 2Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina
Introduction: Chronic pulmonary valve regurgitation is the culprit of mid and long term complications in patients with Tetralogy of Fallot and transannular patch sugical procedure. The Venus p-valve is a self expanding percu- taneous heart valve designed to be implanted in a native patched right ventricle outflow tract. The worlwide clinical experience with this valve is just beginning.
We present our initial experience implanting the Venus p-valve in patients with Tetralogy of Fallot and transannu- lar patch repair.
Methods: 10 patients were evaluated and 6 were selected for percutaneous Venus p-valve implantation. 4 women, 2 men. Mean age was 34 years old (23-46), mean weight 57.5 kg (40-75). All were Tetralogy of Fallot with transannular
Hijazi, Z
22nd Annual PICS/AICS Meeting